The goal of this career development program is to facilitate the candidate's development as a leader in health services research and health policy focused on disparities in healthcare quality and patient-centeredness for vulnerable populations. Building on her background in internal medicine, bioethics and health policy, the candidate proposes to develop additional skills over the course of the award period through: 1) coursework designed to expand her methodological skills; 2) interaction with a multidisciplinary sponsorship team, including experts in health services research (Dr. Daniel Ford), patient-physician communication (Dr. Debra Roter), cross-cultural communication (Dr. Lisa Cooper) and bioethics (Dr. Ruth Faden); and 3) a series of supervised research projects. The specific aims of these research projects are: 1) to evaluate the impact of patient literacy on patient participation in care and patient-physician communication; 2) to test a multidimensional model of vulnerability to poor interpersonal treatment and to evaluate health care system features that moderate the relationship between vulnerability and poor interpersonal treatment; and 3) to develop an instrument measuring cultural competence from the patient's perspective. The research projects were chosen so that she would become proficient with a variety of methodologies, including the conduct and analysis of a randomized controlled trial, analysis of the Medical Expenditure Panel Survey (MEPS), and instrument development/psychometric testing. In the final stages of the award period, the candidate plans to develop a grant proposal to evaluate the relationship between cultural competence, the quality of healthcare, and health outcomes for ethnic minorities. As Assistant Professor of Medicine, she will conduct this research within the Johns Hopkins Schools of Medicine and Public Health which offer extensive resources for health services research and provide a rich intellectual environment for learning.